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General NPI Number Information
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NPI Number | 1952495087
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Entity Type | Organization
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Legal Business Name | GENERAL SURGICAL ASSOCIATES OF N.L., P.C.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 50 FAIR HARBOUR PL SUITE 2-C
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City | NEW LONDON
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State | CT
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Zip | 06320-4731
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Country | US
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Telephone | 860-443-3147
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Fax | 860-443-0087
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Provider Business Mailing Address
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Address Line | 50 FAIR HARBOUR PL SUITE 2-C
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City | NEW LONDON
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State | CT
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Zip | 06320-4731
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Country | US
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Telephone | 860-443-3147
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Fax | 860-443-0087
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Authorized Official
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Title or Position | PRESIDENT/MD
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Name | DR. DEAN NORMAN WILLIS
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Credential | M.D.
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Telephone | 860-443-3147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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